【摘要】 目的探讨鼻内镜下切除鼻内翻性乳头状瘤(nasal inverted papilloma,NIP)的方法及疗效。方法 23例经病理和临床诊断的NIP病例。根据Krouse分级将病变分为4级:I级13例,II级6例,III级3例,IV级1例。术前均行鼻内镜检查及鼻窦CT冠状状+轴位(平扫+增强)或MRI扫描。15例单纯行经鼻内镜肿瘤切除术,7例行鼻内镜手术联合上颌窦根治术,1例鼻内镜手术联合鼻外侧进路。局部麻醉或全身麻醉鼻内镜下先切除鼻腔、筛窦、蝶窦、额窦口、上颌窦口肿瘤及其基部黏骨膜;侵及上颌窦者经柯陆径路,内镜下于骨膜下分离切除肿瘤。结果术后随访2.2～6.3年,中位数4年。治愈21例(91.30%),复发2例(8.70%)。结论鼻内镜对NIP疗效确切,对肿瘤涉及上颌窦的III级病变,联合柯陆手术疗效较好。更多还原

【Abstract】 OBJECTIVE To study the method and effect of endoscopic surgery for nasal inverted papilloma.METHODS Twenty three patients had been diagnosed as nasal-sinus inverted papilloma.We divided the 23 cases into 4 grades according to Krouse classification system: grade I 13 cases,grade II 6 cases,grade III 3 cases,grade IV 1 cases.All of them received preoperative endoscopy and CT scan or MRI.The papillomas were removed under the endoscopic surgery in 15 cases,under the combination of the endoscopic surgery and the Caldwell-Luc surgery in 7 cases,through the lateronasal incision approach in one case.RESULTS All of the cases were routinely followed up for 2.2 to 6.3 years(median 4 years).The cure rate was 91.3%(21 cases).The recurrence rate was 8.7%.CONCLUSION The endoscopic surgery is an effective method for nasal inverted papillomas.Endoscopic plus Caldwell-Luc surgery will be the better method for tumors invaded maxillary sinus.更多还原